NPI | 1982681151 |
---|---|
Former Name | MARIA VIRGINIA AVILA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A89929) |
Additional Taxonomies | 208D00000X General Practice (Licence: CA A89929) |
207Q00000X Family Medicine (Licence: AK 6825) | |
Enumeration Date | 2005-12-28 |
Last Update Date | 2012-05-30 |